Javier Andrés Blumenfeld Olivares

Cardiovascular disease is linked to high serum low density lipoprotein (LDL)-cholesterol levels. Cardiovascular risk may be indirectly influenced by genetic load. Serum LDL-cholesterol levels may be reduced by the consumption of food enriched with plant sterols (PS). The aim was to test a plant sterol treatment on cholesterol levels according to different genetic polymorphisms. A pilot interventional trial was performed in 26 children (n = 16 girls, n = 10 boys). Seven hundred milliliters/day of commercial skimmed milk with added plant sterols delivering 2.2 g plant sterols were ingested for three weeks. Blood draws were performed at the baseline and end of the study. Significant modifications of non-high density lipoprotein (HDL)-cholesterol (p = 0.010; p = 0.013) and LDL-cholesterol (p = 0.004; p = 0.013) levels appeared in the genes LIPC C-514T and PPAR-α L162V carriers. No statistically significant differences were observed for other genes. LIPC C-514T and PPAR-alpha L162V carriers could benefit from a plant sterol supplement to ameliorate hypercholesterolemia.

Background: The aetiology of Attention Deficit Hyperactivity Disorder (ADHD) continues to be debated, although several contributing factors have been acknowledged. Objective: Assess the association between weight, birth attributes, exercise and sleep habits, dietary intake and adherence to a Mediterranean diet, and impulsive behaviour on Spanish ADHD children. Establish whether specific food groups (not just adherence to the Mediterranean diet) associate with impulsive behaviour. Methods: This observational cross-sectional study included 57 ADHD children from Madrid (Spain). Demographic, clinical data, sleep, exercise and technology-use habits were obtained. Anthropometric measurements included height and weight. Adherence to the Mediterranean diet was assessed using the KIDMED test. Barratt Impulsivity Scale version-11c was used to assess impulsivity. Subjects were divided into three groups for analysis, according to their age (6–10 years, children; 11–13 years, pre-adolescents; 14–16 years, adolescents). Results: There were clear associations between those who had higher BIS scores and who slept less at weekends (49.4 ± 10.16 vs. 43.8 ± 12.51), who adhered poorly to the Mediterranean diet (49.9 ± 11.72 vs. 41.6 ± 16.52), who used internet and technological devices for >3 h/day (45.5 ± 13.6 vs. 44.7 ± 12.11), who were born with >2.5 kg (46.1 ± 11.61 vs. 42.9 ± 15.29), who were delivered by caesarean (45.1 ± 12.78 vs. 44.7 ± 12.5) and who were not breastfed (45.0 ± 13.38 vs. 44.8 ± 12.39). Subjects exercising more than 3 days a week also scored slightly higher (45.4±14.02 vs. 44.6±11.85) in the BIS. Conclusion: There is a need to follow up the link between ADHD and sleep onset difficulties, dietary patterns, technological habits, perinatal factors, breastfeeding and birth delivery mode.

Introducción: La metabolómica permite estudiar la resistencia a insulina (RI), un factor de riesgo de pre-diabetes y diabetes. Quantose IRTM es el único test que mide la RI mediante la abrazadera hiperinsulinémica euglicémica. Objetivo: Se comprobó la eficacia de un test metabolómico en la detección de marcadores de RI en población infantil. Materiales y Métodos: Once niños, de edad 8,54±3,53 años y con factores de riesgo de diabetes, fueron reclutados del Hospital El Escorial. Se estableció como criterio diagnóstico para la prediabetes el estándar de la Asociación Americana de Diabetes (ADA) (HbA1C 5,7-6,4% y glucosa basal 100-125mg/dl). Se compararon las analíticas de sangre con la prueba de Quantose IRTM, estudiando el perfil del metaboloma relacionado con la RI (ácido alfa-hidroxibutírico, ácido oleico, linoleo-glicerofosfocolina e insulina). Su análisis generó una puntuación Quantose© (escala 0-100), siendo >63 RI. Resultados: Ningún sujeto cumplió el criterio de la ADA para prediabetes: HbA1C fue 5,3±0,18 % y glucosa 86,6±5,6 mg/dl. Por el contrario, 10 sujetos cumplieron criterios del test Quantose IRTM para la RI (score: 78,09 ± 9,24 (>63)). Conclusiones: El test Quantose IRTM mide el porcentaje de hemoglobina unida a glucosa dentro de los glóbulos rojos. Permite prever el riesgo de diabetes, y tomar medidas preventivas.

Introduction: Genetic load may indirectly influence on cardiovascular risk. This work aimed to analyze the influence of polymorphisms (APOA5 C56G-Ser19Trp, Prothrombin-G20210A, F5 Arg506Gln, MTHFR-C677T, LIPC-C-514T, LPA-I4300M, PPAR_ALPHA-L162V, APOA5-1131T > C, APOE-APOE2/3/4, and APOE-APOE2,3,4) in plasma triglyceride (TG) levels of patients ingesting plant sterols. Materials and Methods: Double-blind, crossover, controlled clinical trial was performed in 45 individuals (25 women). About 2.24 g sterols in milk and placebo milk were ingested daily during 3 weeks each, separated by a 2-week washout period. Blood draws and saliva genomic DNA was extracted. Results: APOA5-C56G-Ser19Trp, MTHFR-C677T, and PPAR_ALPHA-L162V greatly benefit from sterols intake. APOA5-C56G-Ser19Trp GG homozygous carriers lowered their TGs more than CG heterozygote carriers (P = 0.003). TT homozygous carriers of gene LIPC C-514T experienced an increase of TGs. Conclusions: Further studies are needed to establish which genotype combinations is the most protective against hypertriglyceridemia.

Background: Dyslipidemias have increased during the last decades in children. Aim: The objective of this study was to analyze the influence of different polymorphisms in plasma triglyceride levels of children following a dietary treatment with plant sterols. Design: A randomized, double-blind, crossover, controlled clinical trial was carried out in 26 children (16 women). Materials and Methods: Commercial milk, with 2.24 g sterols, was ingested daily during 3 weeks , and the same amount of skimmed milk without sterols, during the 3 week placebo phase. Both phases were separated by a washout period of 2 weeks. At the beginning and end of each phase, blood draws were performed. Results: Apolipoprotein A5 Ser19Trp (P = 0.002), peroxisome proliferator-activated receptor-alpha L162V (P = 0.003), APOE APOE2/3/4 (P = 0.012), and APOE APOE2,3,4 (P = 0.025) show statistically significant differences between their haplotypes in plasma triglyceride levels. Other genes did not show statistically significant differences. Conclusions: Further studies are needed to establish which genotype combinations would be the most protective against hypertriglyceridemia.

Raised serum cholesterol concentration is a well-established risk factor in cardiovascular disease. In addition, genetic load may have an indirect influence on cardiovascular risk. Plant-based sterol-supplemented foods are recommended to help reduce the serum low-density lipoprotein cholesterol level. The objective was to analyse the influence of different polymorphisms in hypercholesterolemia patients following a dietary treatment with plant sterols. A randomised double-blind cross-over controlled clinical trial was carried out in 45 people (25 women). Commercial milk, containing 2.24 g of sterols, was ingested daily during a 3-week period, and then the same amount of skim milk, without sterols, was consumed daily during the 3-week placebo phase. Both phases were separated by a washout period of 2 weeks. At the beginning and end of each phase, blood draws were performed. Genes LIPC C-514T and APOA5 C56G are Ser19Trp carriers and greatly benefit from sterol intake in the diet. LIPC C-514T TT homozygous carriers had lower low-density lipoprotein cholesterol (LDL-c) levels than CC homozygote and CT heterozygote carriers after the ingestion of plant sterols (p = 0.001). These two genes also showed statistically significant changes in total cholesterol levels (p = 0.025; p = 0.005), and no significant changes in high-density lipoprotein (HDL) cholesterol levels (p = 0.032; p = 0.003), respectively. No statistically significant differences were observed for other genes. Further studies are needed to establish which genotype combinations would be the most protective against hypercholesterolemia.

Attention-deficit hyperactivity disorder (ADHD) has been related to nutrient deficiencies and 'unhealthy' diets, and to date there is only one study that examined the relationship between the Mediterranean diet and ADHD. The aim was to determine the association between those environmental, nutritional, and body composition factors that may affect the pathogenesis and symptomatology of patients with ADHD in Spain. A total of 89 children and adolescents (41 with diagnosed ADHD and 48 controls) were studied in an observation case-control study. Anthropometry, nutritional status, adherence to a Mediterranean diet, sedentary behaviour, and sleep were measured. Lower adherence to a Mediterranean diet was associated with ADHD diagnosis. Individuals with ADHD more often missed having a second serving of vegetables daily and showed reduced intakes of fish, pulses, and pasta or rice almost every day when compared with controls. Statistically significant differences (P < 0.05) were found for fish, cereal, no breakfast and commercially baked goods consumption. There were also statistically significant differences between ADHD individuals and controls when analysing sedentary behaviours and BMI (P < 0.05). Low adherence to a Mediterranean diet might play a role in ADHD development. Not only specific nutrients but also the whole diet should be considered in ADHD. No clear association was found for anthropometry and sedentary behaviours.

Introducción: la hipercolesterolemia es uno de los principales factores de riesgo en la enfermedad cardiovascular. Los esteroles vegetales sehan postulado como agentes reguladores y benefi ciosos para el control de esta.Objetivo: analizar el efecto de los esteroles vegetales añadidos en una leche en la reducción del colesterol plasmático en adultos jóvenes.Métodos: ensayo clínico, controlado, aleatorizado, doble ciego y cruzado. Los esteroles (2,24 g diarios) fueron administrados en dos tomasde 350 ml de una leche comercial desnatada, durante dos periodos de 3 semanas, separados por una “fase de lavado” de 2 semanas, en elgrupo experimental. Al grupo control se le administró la misma cantidad de leche desnatada, sin esteroles. Tanto al inicio como al fi nal de cadaperiodo de intervención se extrajeron muestras sanguíneas. Se analizaron la composición corporal, hábitos de salud y los siguientes marcadoressanguíneos: perfi l lipídico, hematológico, infl amación, etc.Resultados: se incluyeron 54 personas en el estudio con una edad media de 38,8 ± 7,3 años. La diferencia porcentual entre los marcadoresbasales y fi nales para el colesterol total, colesterol-LDL, colesterol-HDL, triglicéridos y colesterol no-HDL fueron del 9,73%, 12,5%, 1,9%, 3,15%y 13,2%, respectivamente. Se obtuvieron diferencias estadísticamente signifi cativas entre el grupo experimental y el grupo control, para todoslos marcadores analizados excepto para los triglicéridos.Conclusión: los esteroles vegetales suministrados en un alimento de consumo habitual, como la leche, pueden ser una estrategia terapéuticano farmacológica para el control de la hipercolesterolemia de alto interés sanitario.